Most adults who suffer from a chronic illness are married or in an intimate relationship, yet the vast majority of behavioral interventions fail to address this relationship's impact or the effects of illness on the partner. Therefore, such interventions are not likely to be fully effective for many patients, and may even backfire. The purpose of this proposed K02 Independent Scientist Award (ISA) to Dr. Lynn Martire is to advance the development of couple-oriented interventions (CIs) for chronic illness that benefit both patients and spouses and also inform models of marriage and health. The focus of this award will be three chronic conditions that are the most deadly and costly of all health problems in the United States: cardiovascular disease, cancer, and diabetes. Dr. Martire's career development activities will address design, measurement, and analysis issues that are critical for the success of future CI research. The research activities of this ISA will add critical information to the literature on marriage and health, and inform the next generation of CIs, by focusing on how short-term processes that occur in the home environment affect health. Aims #1 and 2 will examine daily processes in couples living with chronic illness, as well as individual and couple-level characteristics that moderate these processes, using dyadic diary data collected in studies of knee osteoarthritis and Type 2 diabetes. Aim #3 is to collect pilot observational data on couples' health-related interactions in the home. Aim #4 will apply findings from these and other projects to the development of an adaptive, cross-disease intervention for couples. The Candidate is uniquely poised to make significant advances in this area due to her research expertise in late-life chronic illness, family caregiving, and the effects of intervention on both patient and caregiver. Research and training activities will be facilitated by a team of Consultants who are leading experts in the areas of intimate relationships, health, longitudinal measurement and analysis, intervention development, and ecological momentary intervention. In addition, the Candidate has assembled a National Working Group of established researchers testing CIs for the three focal conditions of this ISA. PUBLIC HEALTH RELEVANCE: Chronic illnesses account for 70% of all deaths in the United States and more than 75% of the nation's medical care costs. These conditions are most prevalent in middle-aged and older adults, and the majority of these individuals are married or in an intimate relationship. In order to contain escalating health care costs in the future, it is critical to identify strong behavioral approaches that target this relationship's impact on health.